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15080101CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10355 N DE ANZA BLVD CONTRACTOR: STATEWIDE ROOFING PERMIT NO: 15080101 INC OWNER'S NAME: VIDOVICH- CUPERTINO LIMITED PARTNERS 5542 MONTEREY RD DATE ISSUED: 08/13/2015 OWNER'S PHONE: 4089749575 SAN JOSE, CA 95138 PHONE NO: (408)288 -8680 IkI LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL LAY OVER (E) B.U.R. & APPLY (N) .60 MIL T.P.O. License Class G'/ Cf Lic. # P/a ?� Q �-� ROOFING SYSTEM (219 SQ'S) / Contractor S� 1CV Jw fi0/7K ate (194 l3 C)15 I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self - insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the Sq. Ft Floor Area: Valuation: $125000 performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this APN Number: 32633113.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save I INSPEC ION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will co ue b Date: with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature to US71 % /2 RE- ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant: e: LaJ 13 1 9 ❑ OWNER- BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of �RR the following two reasons: ALL ROOF COVERINGS TO BE A " OR BETTER I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(a) should I store or handle hazardous I have and will maintain a Certificate of Consent to self - insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 25533=2n25534 . Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: ate• !/ W44 permit is issued. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, I CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, ARCHITECT'S DECLARATION costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature Date CUPERTINO REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 • FAX (408) 777 -3333 • building(ftupertino.org / PROJECT ADDRESS �55, N. De Anza Blvd. _7N" Jl3 OWNERNAME II do V Pc. .CVp Apple, Inc ' �� �. PHONE 408 974 -9575 ( ) E -MAIL STREET ADDRE�� e ,Q �C� � Sun CITY, ST "rr oro 1°� CA _ _ 4 tlC>2 cas FAX CONTACT NAME Michael Courtney PHONE 408 - 286 -7828 E -MAIL mcourtney @swroof.net STREET ADDRESS 5542 Monterey Road, #201 CITY, STATE, ZIP San Jose, CA 95138 FAX 408- 286 -7820 ❑ OWNER ❑ OWNER - BUILDER ❑ OWNER AGENT IX CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME Michael Courtney LICENSE NUMBER 803926 LICENSE TYPE C39 BUS. LIC.# 23509 COMPANY NAME Statewide Roofing, Inc. E -MAIL mbotill @swroof.net FAX 408 - 286 -7820 STREET ADDRESS 5542 Monterey Road, #201 CITY, STATE, ZIP San Jose, CA 95138 PHONE 408 - 286 -7828 ARCHITECT/ENG VEER NAME LICENSE NUMBER BUS. LIC. # COMPANY NAME E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF ❑ SFD or Duplex ❑ Multi - Family STRUCTURE: C Commercial ROOF AREA: 21,900 sf VALUATION: $125,000 EXISTING ROOF TYPE: IR BUILT -UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY) REMOVE /REPLACE ❑ YES ® NO IF NO, #LAYERS: 1 PLYWOOD ❑ h" ❑ THICKNESS: ❑ 518" PLYWD ❑ OSB TYPE: ❑ CDX PITCH: 25 :12 ROOF 1 CLASS: A PROPOSED ROOF TYPE: ❑ BUILT -UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES N OTHER •60 mil TP [CC-ES REPORT # DESCRIPTION OF WORK: Clean and prepare existing roof and overlay with .60 mil TPO roofing system. By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's be . I have read this application and the information I have provided i correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to b c I authorize representatives of Cupertino to enter the above - identified property for inspection purposes. Signature of Applicant/Agent: Date: 8/13/15 SUPPLEMENTAL INFO ATION REQUIRED _ If building is associated with a Home Owner's Association, provide letter of approval from HOA. Provide Planning approval to verify if there any restrictions. Provide copy of Manufacturers Installation Specifications. Provide signed copy of Cupertino's Tear -Off Policy. OFFICE USE ONLY PLAN CHECK TYPE ROUTING SLIP R- THE - COUNTER ❑ EXPRESS ❑ STANDARD ❑ BUILDING PLAN REVIEW ❑ PLANNING PLAN REVIEW ❑ EIRE DEPT ❑ OTHER: ReroofApp_201 1. doc revised 03116111 �� CITY OF CUPERTINO I�JSiI FEE ESTIMATOR — BUILDING DIVISION FEE ID ROOF AREA s.f. 1REROOFCOM 21,900 : ow, " ' — c ?m p . ' ,Mech. Plan Check Plumb. flan Check Elec. 1'ian C.`hec? Fllech Permit Fee' Plumb. Permit Fee: flee Permit Fee: tither : /cch. Insp. 01her Plumb Imp. tither Oec. Insp. A, /ech. Insp. Fee: Phimb. hash. hee: Elec. lnsp. lee: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School Metrirt_ otr_ )_ Thoco foot Oro hacod an tho nroliminary infarmatian availahlo and Oro anhr an octimato_ Contort tho Dont far addn'1 info_ FEE ITEMS (Fee Resolution 11 -053 E . 711113) 10355 N DE ANZA BLVD DATE: 08/13/2015 REVIEWED BY: MELISSA IlaADDRESS: APN: 326 33 113 BP #: *VALUATION: 1$125,000 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re -roof PRIMARY USE: Commercial Building 1'lz�mb.L�llc:c•la.; �lc�c PENTAMATION PERMIT TYPE: 1 COMMLROO i WORK OVER E B.U.R. & APPLY (N).60 MIL T.P.O. ROOFING SYSTEM [LAY SCOPE Suppl. Insr? Pee FEE ID ROOF AREA s.f. 1REROOFCOM 21,900 : ow, " ' — c ?m p . ' ,Mech. Plan Check Plumb. flan Check Elec. 1'ian C.`hec? Fllech Permit Fee' Plumb. Permit Fee: flee Permit Fee: tither : /cch. Insp. 01her Plumb Imp. tither Oec. Insp. A, /ech. Insp. Fee: Phimb. hash. hee: Elec. lnsp. lee: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School Metrirt_ otr_ )_ Thoco foot Oro hacod an tho nroliminary infarmatian availahlo and Oro anhr an octimato_ Contort tho Dont far addn'1 info_ FEE ITEMS (Fee Resolution 11 -053 E . 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: SuppL Pt:' Fee 1'lz�mb.L�llc:c•la.; �lc�c Permit Fee: $1,647.00 Suppl. Insr? Pee 1'lzirnb.; �i�!1Gt't�.i Flee I'lz�nth.:'11 ch. %1 lec Permit Fee: Construction .Tax: Achninlstrative Fee: Work Without Permit? 0 Yes E) No $0.00 Advanced Planning Fees: 7i°m,el Docurnentalurn Fees: Strong Motion Fee: IBSEISMICO $35.00 Select an Administrative Item Bldg; Stds Commission Fee: IBCBSC $5.00 Zn ' �, $1,687.00 $0.00v,9 `'s, TO L FEE $1,687.00 Revised: 07/02/2015 CUPERTINO REROOF TEAR -OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 • FAX (408) 777 -3333 • building(afcupertino.org 156'3(0101 PROJECT ADDRESS 10355 N. De Anza Blvd. APN a 3 Z� 3 3 OWNER NAME Apple, Inc. 10 v v ` vp PH E -MAIL STREET ADDRESS !� A,. CITY, STATE, Z­1­054,17$ CAA ` 7 .� FAX CONTRACTOR NAME Michael Courtney LICENSE NUMBER 803926 LICENSE TYPE C39 BUS. LIC. $ 23509 COMPANY NAME Statewide Roofing, nc. 9, E -MAIL mbotill swroof.net @ FAX 408 - 286 -7820 STREET ADDRESS 5542 Monterey Road, #201 CITY, STATE, ZIP San Jose, CA 95138 PHONE 408- 286 -7828 I UNDERSTAND AND AGREE TO THE FOLLOWING: 1. The re -roof project shall comply with all applicable provisions of the 2010 California Codes. 2. An inspection request can be scheduled up to the day before the inspection date. Please call (408)777- 3228 from 7:30 - 3:30pm (Mon - Thurs) or 7:30 - 2:30pm (Friday) to schedule the next day inspection. For Tear -Off and Nailing Inspections, you must also call on the day of the inspection only after that phase of the work is completed. The building inspector will be available within one hour. Progress and Final Inspections will be given a two hour window. 3. Tear -Off Inspection is required. Any and all dry -rotted wood shall be replaced prior to this inspection. Unless new plywood roof sheathing is proposed throughout, all the nails /fasteners shall be either completely knocked -down or removed prior to this inspection. 4. If plywood is installed, a plywood Nailing Inspection is required. 5. Roofing shall not be applied without first obtaining all prior inspection and written approvals from the building inspector. Any roofing which is applied without first obtaining an approved inspection will require the removal of all new material down to the sheathing so a proper inspection can be performed. 6. Progress Inspection is required when approximately 50% of roof covering is installed. 7. A Final Inspection and approval shall be obtained from the building inspector when the re- roofing is completed. To receive a final sign -off, the following items will be verified: a. Flat roofs shall have a minimum of I/" per foot of slope and demonstrate there is no ponding. b. Listings from approved testing agencies for all pre - manufactured products used shall be available on -site to review at the time of the inspection. c. Proper spark arrestor installation, vents painted, gutter /downspouts installed, debris removed. 8. NOTE: If you call for a tear -off or plywood nailing inspection and the work is not complete, you will be charged a re- inspection fee of $126.00. The re- inspection fee shall be paid before another inspection can be scheduled. By my signing below, I certify each of the following is true: I am the property owner or authorized agent to act on the property owner's behalf. I understand and agree to comply with the re -roof policy stated above. I also understand that smoke detectors and carbon monoxide det c ors a required to be installed in accordance with Sections R314 and R315 of the 2010 California Residential Code. Signature of Applicant /Agent: Date: 8/13/15 rceroojroucy_zuw i.aoc revesea uzli oli i